<%@ include file="/common/taglibs.jsp"%>

<head>
<title><fmt:message key="edit.hospital.title" /></title>

<style type="text/css">
div.two_col_left_box {
	float: left;
	padding: 0px;
	width: 380px;
	border: 0px solid gray;
	font-family: "HelveticaNeue-Light", "Helvetica Neue Light",
		"Helvetica Neue", Helvetica, Arial, "Lucida Grande", sans-serif;
	font-weight: 300;
}

div.two_col_right_box {
	float: right;
	padding: 0px;
	width: 380px;
	border: 0px solid gray;
}

div.three_col_left_box {
	float: left;
	padding: 0px;
	width: 270px;
	border: 0px solid gray;
}

div.three_col_mid_box {
	float: left;
	padding: 0px;
	width: 270px;
	border: 0px solid gray;
}

div.three_col_right_box {
	float: left;
	padding: 0px;
	width: 270px;
	border: 0px solid gray;
}

div.form_row {
	width: 840px;
	padding: 1px;
	overflow: hidden;
	border: 0px solid gray;
	font-family: verdana;
	padding: 10px;
}

div.section_header {
	width: 840px;
	height: 26px;
	color: #FFFAFA;
	display: table-cell;
	vertical-align: middle;
	background-color: #545454;
	padding: 0 5px 2px;
	font-family: serif;
	font-size: 14px;
}
</style>
</head>

<body class="editHospital" />

<div class="span12">
	<s:form name="editHospitalForm" action="updateHospitalStatus.action"
		enctype="multipart/form-data" method="updateStatus" validate="true"
		cssClass="well form-vertical">

		<s:hidden key="id" />
		<input type="hidden" name="from" value="${param.from}" />
		
		<div class="section_header">
			<b>HOSPITAL INFORMATION</b>
		</div>

		<div class="form_row">
			<div class="three_col_left_box">
				<b> Hospital Name : </b>
				<s:property value="%{hospital.name}" /> 
			</div>

			<div class="three_col_mid_box">
				<b> Registration Number : </b>
				<s:property value="%{hospital.registrationNumber}" />
			</div>

			<div class="three_col_right_box">
				<b> Zone : </b>
				<s:property value="%{hospital.zones.name}" />
			</div>
		</div>

		<div class="form_row">
			<div class="three_col_left_box">
				<b> Phone Number : </b>
				<s:property value="%{hospital.phoneNumber}" />
			</div>

			<div class="three_col_mid_box">
				<b> Mobile Number : </b>
				<s:property value="%{hospital.mobileNumber}" />
			</div>

			<div class="three_col_right_box">
				<b> Fax : </b>
				<s:property value="%{hospital.fax}" />
			</div>
		</div>

		<div class="form_row">
			<div class="three_col_left_box">
				<b> Number of beds : </b>
				<s:property value="%{hospital.beds}" />
			</div>

			<div class="three_col_mid_box">
				<b> Hospital Type : </b>
				<s:property value="%{hospital.hospitalType}" />
			</div>

			<div class="three_col_right_box">
				<b> Status : </b>
				<s:property value="%{hospital.status}" />
			</div>
		</div>

		<div class="form_row">
			<div class="three_col_left_box">
				<b> Email : </b>
				<s:property value="%{hospital.email}" />
			</div>

			<div class="three_col_mid_box">
				<b> Website : </b>
				<s:property value="%{hospital.website}" />
			</div>

			<div class="three_col_right_box">
				<b> Address : </b>
				<s:property value="%{hospital.address}" />
			</div>

		</div>

		<div class="section_header">
			<b>PRIMARY CONTACT PERSON INFORMATION</b>
		</div>

		<div class="form_row">
			<div class="three_col_left_box">
				<b> Contact Person : </b>
				<s:property value="%{hospital.contactPersonName}" />
			</div>

			<div class="three_col_mid_box">
				<b> Mobile Number : </b>
				<s:property value="%{hospital.contactPersonMobile}" />
			</div>

			<div class="three_col_right_box"></div>
		</div>
		
		<div class="form_row">
			<div class="three_col_left_box">
				<fieldset class="control-group">
					<label for="status" class="control-label"><fmt:message
							key="hospital.status" /></label>
					<div class="controls">
						<select id="status" name="updatedStatus">
							<s:iterator value="statusList" var="varStatus">
								<option value="<s:property value="label"/>"
									${fn:contains(varStatus.label, hospital.status) ? 'selected' : ''}>
									<s:property value="value" />
								</option>
							</s:iterator>
						</select>
					</div>
				</fieldset>
			</div>

			<div class="three_col_mid_box">
			ddtetest11
			</div>

			<div class="three_col_right_box">
				
			</div>
		</div>

		<fieldset class="form-actions">
			<s:submit key="button.save"  method="updateStatus" cssClass="btn btn-primary" theme="simple"/>
			<s:submit key="button.cancel" method="cancel" cssClass="btn"
				theme="simple" />
		</fieldset>
	</s:form>

</div>

